The Value of Multifrequency Tympanometry in the Management of Otitis Media with Effusion

Abstract

Tympanometry, which is a non-invasive, quick, and inexpensive method, has been widely used for examining the middle-ear function. Tympanometry performed using conventional 226 Hz probe tone frequency has proven valid in identifying a variety of middle ear disorders [1]. However, conventional 226-Hz tympanometry often fails to distinguish normal middle ears from ears with pathologies that affect the ossicular chain [1-5]. Multifrequency tympanometry (MFT) is an advanced, recently clinically established, sweep-frequency or sweep-pressure method of acoustic immittance measurement. MFT provides values for the resonance frequency (RF) of the middle ear; this is the frequency in which the total susceptance is zero [4,6,7]. Otitis media with effusion (OME) is one of the most common ear diseases of childhood world [8-10]. Diagnosis of OME with TT remains a challenging situation especially in neonates and toddlers [11]. TT has some shortcomings and may yield misdiagnosis of patients. The positive predictive value of an abnormal (flat, type B) tympanogram has been shown to be between between 49 and 99 percent [12]. A type C (negative pressure) curve itself, is an imprecise estimate of middle ear pressure and does not have high sensitivity or specificity for middle ear disorders [12]. There is growing evidence for MFT to be superior than TT in the diagnosis and follow-up of patients with otitis media [13-15]. The middle ear RF has been demonstrated to be declined in patients with OME [16]. There is little information about follow-up or treatment differences regarding consistency of the effusion in OME. It is advocated in an experimental study that, mucoid effusion can undergo a process of organization and may end up with granulation tissue and cholesterol granuloma [17]. Diagnostic value of TT and MFT in differentiating mucoid OME from serous OME is not well studied. Background: There is little evidence about the value of multifrequency tympanometry (MFT) in children with otitis media with effusion (OME). Purpose: To evaluate the diagnostic value of the ear resonance frequency (RF) and 226 Hz traditional tympanometry (TT) among children with OME. Research design: Cross-sectional controlled study.

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